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Objective. The choice of surgical tactics in patients with synchronous colorectal cancer metastases in the liver requiring extensive resection is rather difficult. This study was held to evaluate the immediate results of simultaneous operations with extensive liver resections compared to staged surgical interventions. Material and methods. From January 2013 to March 2016 40 patients with synchronous colorectal cancer metastases in the liver underwent extensive resection of the liver: 20 simultaneous operations (group 1) and 20 staged surgical interventions (group 2). Central liver resection (2/10%) and extended hemihepatectomy (5/25%) were performed only in the staged operations group (p = 0.062). For primary tumors in both groups resections of the rectum were mainly done: 15 (75%) and 12 (60%), respectively. Results. The results of group 2 are given in total after the first and second operations. Mortality in groups 1 and 2 was 0 and 1 (5%), respectively (p = 1.0). The frequency of complications amounted to 10 (50%) in both groups (p = 1.0). Hepatic failure was observed only in the group of staged operations for patients with extended hemihepatectomy: 3 (15%), p = 0.2. Biliary fistula was observed in 3 (15%) patients of group 1, and in 2 (10%) patients of group 2, p = 1.0. The median blood loss was less in the group of simultaneous operations than in group of staged operations (375 vs. 850 ml, p = 0.035). Postoperative hospital stay in the group of simultaneous liver resections compared with the second stage of surgical treatment in group 2 was similar and amounted to 19 (15;28), and 19 (14;21), respectively (p = 0.4). Conclusion. Simultaneous operations consisting of standard resection of the large intestine and removal of up to 70% of the liver parenchyma do not increase the frequency, the structure of complications and mortality in comparison with the staged interventions, as well as do not increase the periods of postoperative recovery.

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